By J M Villalba
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B, Color Doppler, Transverse. C, Longitudinal. 37-Year-old woman • Clinical history: Two cold nodules at scintigraphy • Ultrasound: Papillary thyroid carcinoma (PTC), isthmus/ left lobe. Colloid cyst in left lobe. • Cytology: PTC • Thyroidectomy: PTC in isthmus. Cystic colloid nodule in left lobe Features Isoechoic Homogeneous echo pattern Small cyst with calcifications Not clearly circumscribed Scantly vascularized See also pages 162–163 26 FIGURE 3–11. Histology: nodule rich in colloid in the center.
Ultrasound of a hyperplastic nodule in the right lobe. A, Transverse, 10 x 13 mm. B, Color Doppler, Transverse. C, Longitudinal, sagittal diameter: 14 mm. 47-Year-old woman • Clinical history: Nodular goiter and autoimmune thyroiditis for many years • Ultrasound: Probably papillary thyroid carcinoma left lobe and colloid nodule in right lobe • Cytology: Hyperplastic nodule • Thyroidectomy: Papillary carcinoma with follicular differentiation in left lobe. Excessive Hashimoto’s thyroiditis. Hyperplastic nodule right lobe.
Ultrasound of a colloid nodule in the left lobe. A, Transverse, 23 x 45 mm. B, Color Doppler, Transverse. C, Longitudinal, sagittal diameter: 66 mm. 39-Year-old woman • Clinical history: Palpable tumor in left lobe unchanged for more than 1 year • Ultrasound: Colloid nodule? Follicular adenoma? • Cytology: No diagnostic material • 18-Gauge histologic needle biopsy: Follicular tissue without atypia • Left hemithyroidectomy: Colloid nodule Features Slightly hypoechoic Inhomogeneous spongy echo pattern Well circumscribed Thin partial hypoechoic halo A few microcalcifications Suggestion of “spoke-and-wheel-like” vascularity 44 FIGURE 3–39.